不同实时超声弹性成像技术诊断桥本甲状腺炎合并结节的临床应用价值分析  

Analysis on the clinical application value of different real-time ultrasound elastography techniques in diagnosing HT combined with nodule

作　　者：王春莉 许黎阳 刘向辉 常青[2] 牛丽娟[2] WANG Chun-li;XU Li-yang;LIU Xiang-hui(Department of Ultrasound Medicine,The Number No.1 Hospital of Zhangjiakou,Zhangjiakou 075000,China;不详)

机构地区：[1]张家口市第一医院超声医学科,河北张家口075000 [2]中国医学科学院肿瘤医院超声医学科,北京100021

出　　处：《中国医学装备》2021年第5期92-96,共5页China Medical Equipment

摘　　要：目的:探讨剪切波弹性成像(SWE)技术、超声弹性成像评分以及弹性应变率比值(SR)在桥本甲状腺炎(HT)合并结节诊断中的临床应用价值。方法:选取在医院接受实时超声弹性成像检查的67例HT合并结节患者影像学资料,其中单发结节67个,经组织病理学检查诊断恶性结节31个,良性结节36个;分别以SWE杨氏模量值、超声弹性成像评分诊断结果、SR及其联合诊断结果为检验变量,病理检查结果为状态变量,绘制受试者工作特征(ROC)曲线,分析SWE、弹性成像评分、SR及其联合诊断在HT合并结节诊断的效能。结果:病理检查确诊恶性结节患者SWE杨氏模量值显著高于良性结节患者(t=9.821,P<0.001),其诊断HT合并结节的ROC曲线下面积(AUC)为0.919,临界值为31.65 kPa,灵敏度为87.10%,特异度为94.44%;超声弹性成像评分诊断HT合并结节的AUC为0.852,灵敏度为87.10%,特异度为83.33%;HT合并恶性结节患者的SR显著高于良性结节患者(t=6.462,P<0.001),SR诊断HT合并结节的AUC为0.866,临界值为5.43,灵敏度为70.97%,特异度为100.00%;单一技术诊断时以SWE的AUC最高;3种技术联合诊断HT合并结节的AUC升至0.956,灵敏度、特异度分别为96.77%和94.44%。结论:实时超声弹性成像技术对HT合并结节均能发挥一定的诊断效能,以SWE的诊断效能最佳,且其与超声弹性成像评分、SR联合可进一步提升诊断效能。Objective:To investigate the clinical application value of shear wave elastography(SWE),ultrasound elastography score and the ratio of elastic strain rate(SR)in diagnosing Hashimoto's thyroiditis(HT)combined with nodule.Methods:The imaging data of 67 patients with HT combined with nodule who received real-time ultrasound elastography examination were selected.There were 67 solitary nodules,and 31 malignant nodules and 36 benign nodules were confirmed by histopathological examination.SWE Young's modules value,the diagnosis results of ultrasound elastography score,SR and the combined diagnosis results were regarded as test variables,while histopathological examination results were regarded as state variables to plot the receiver-operating characteristic(ROC)curve so as to analyze the diagnostic efficacies of SWE,elastography score,SR and the combined diagnosis for HT combined with nodule.Results:SWE Young's modulus value of patients with malignant nodules was significantly higher than that of patients with benign nodules as the confirmation of histopathological examination(t=9.821,P<0.001).The area under the curve(AUC)of receiver operating characteristics(ROC)curve of that in diagnosing HT combined with nodule was 0.919,and the critical value was 31.65,and the sensitivity was 87.10%,and the specificity was 94.44%.And the AUC of ultrasound astography score was 0.852 in diagnosing HT combined with nodules.And the sensitivity and specificity of that were 87.10%and 83.33%,respectively.The SR of patients with HT combined with malignant nodule was significantly higher than that of patients with benign nodule(t=6.462,P<0.001).The AUC of SR in diagnosing HT combined with nodule was 0.866,and the critical value was 5.43,and the sensitivity and specificity were 70.97%and 100.00%,respectively.In the diagnosis with single technique,the AUC of SWE was highest,and the AUC of the combined diagnosis with three kinds of techniques was increased to 0.956 for HT combined with nodule,and the sensitivity and specificity of the combined

关 键 词：剪切波弹性成像技术(SWE) 超声弹性成像评分 弹性应变率比值(SR) 桥本氏甲状腺炎(HT) 结节 

分 类 号：R445.1[医药卫生—影像医学与核医学]